A facet joint block is a minimally invasive pain management procedure used to diagnose and treat chronic back or neck pain originating from the facet joints — the small joints located between the vertebrae that provide stability and motion to the spine. These joints can become painful due to degeneration, arthritis, or trauma, leading to localized pain, stiffness, or radiating discomfort. Facet joint blocks are performed under fluoroscopic (X-ray) or CT guidance to ensure precision and safety.
Indications
Facet joint blocks are recommended for:
- Chronic neck or low back pain not relieved by medication or physiotherapy
- Pain after whiplash or minor spinal trauma
- Facet joint arthritis or spondylosis seen on imaging
- Pain worsened by extension or twisting movements
- Diagnostic confirmation before radiofrequency ablation (RFA)
Facet-mediated pain is often localized, non-radiating, and associated with morning stiffness or motion restriction.
Procedure
1. Preparation
- The procedure is done in an outpatient setting, usually under local anesthesia with or without mild sedation.
- The patient lies face down (for lumbar) or face up (for cervical).
- Using real-time fluoroscopy, the target facet joint or medial branch nerve is precisely identified.
2. Injection Technique
A fine needle is advanced toward the affected joint or nerve. After confirming correct placement with a small amount of contrast dye:
- A mixture of local anesthetic and anti-inflammatory steroid is injected.
- For diagnostic blocks, only anesthetic is used to confirm whether the pain originates from that joint.
The procedure typically takes 10–20 minutes and does not require general anesthesia.
3. Post-Procedure Care
- Patients are observed briefly for vital signs and possible side effects.
- Most can walk and return home the same day.
- Temporary numbness or mild soreness at the injection site may occur but resolves quickly.
Expected Results
- Diagnostic blocks help determine if the facet joint is the pain source — if pain relief occurs, this confirms the diagnosis.
- Therapeutic blocks can provide weeks to months of pain relief, especially when inflammation is significant.
- If pain relief is temporary, patients may benefit from radiofrequency ablation (RFA) of the medial branch nerves for longer-lasting results (6–12 months).
Risks & Complications
Facet joint blocks are generally safe when performed under image guidance, but potential risks include:
- Mild injection site pain or bruising
- Temporary numbness or weakness
- Allergic reaction to medication or contrast dye
- Very rare: infection or bleeding
Severe complications are extremely uncommon with proper technique.
Recovery & Follow-Up
- Rest is advised for 12–24 hours after the injection.
- Most patients resume normal activities the next day.
- Pain relief can begin within hours or may take a few days if steroids are used.
- Follow-up evaluation helps determine whether additional treatment or RFA is indicated.
Combined with physiotherapy and posture correction, facet blocks can significantly improve spinal mobility and quality of life.
Patient Advisory
Treatment decisions for facet joint pain are individualized. Not every patient with back or neck pain will benefit from injections — proper clinical and radiological assessment is essential. Only your treating specialist can determine whether a facet joint block or alternative therapy is appropriate. Do not make medical decisions based solely on online information.